Frequently Asked Hyperhidrosis Questions - Armpit Sweating, Foot Sweating and more

Here are some frequently asked Hyperhidrosis Questions we have received over time.

My doctor is not familiar with hyperhidrosis, what shall I do?

As a matter of fact the topic of hyperhidrosis is not well known amongst primary care doctors or otherwise. The reason is that the subject is not very well understood as well as the fact that it is not always taken seriously by the treating physicians. Only the people who suffer through hyperhidrosis on a daily basis understand the full impact of what its like. It takes time for this subject to be more appreciated and thanks to the existence of the Internet much can be learned about the disease itself, its basis, and the possibilities of conservative as well as surgical treatments.

Is there a procedure just for my excessive foot sweating?
Plantar hyperhidrosis (excessive foot sweating) typically comes together with primary palmar hyperhidrosis (excessive hand sweating).

Performing thoracic sympathectomy might help plantar hyperhidrosis in about 25% of the cases. Since about 2007 an improved procedure, lumbar sympathectomy was developed for patients for whom thoracic sympathectomy did not help at all for excessive foot sweating. The procedure is also for those patients that had plantar hyperhidrosis as their primary sweating problem. The operation, lumbar sympathectomy, can be done through very small incisions on both sides of the abdomen and it takes about 2 hours to perform. The success rate is about 98% and offers a good viable option for those patients with severe plantar hyperhidrosis (excessive foot sweating). Both operations cannot be done at the same time. It is customary to wait 3-4 months between the operations (ETS & ELS). This procedure is now offered on an outpatient basis.

One of the very first doctors to offer this improved procedure in the U.S is hyperhidrosis expert Dr. Reisfeld in Los Angeles. To learn more visit his page on excessive foot sweating.

What is the cost of the hyperhidrosis surgeries?

Prices do vary between each surgeon and the specific procedure to be performed (Hands, Feet, Armpits). It is always recommended to talk with the surgeons office about specific details. Often times insurances companies will cover the procedures and the best verify this is through the surgeons office. They are likely very experienced with the verification process and will save you time.

On the other hand if a patient does not have any insurance or is outside of the U.S. the price can be discussed with the surgeon.

What to do with excessive armpit (axillary) sweating?
For those patients whose main problem is excessive armpit sweating (Medically known as Axillary Hyperhidrosis) ETS is not the right solution. For those patients the local procedure known as suction curretage & subdermal laser ablation is the best approach. With this procedure scraping or suctioning of the sweat glands in the armpit region should be done as the first approach only if conservative measures such as Drysol or Botox failed. The advantage of this procedure over ETS is that the success rate is higher, there are almost no generalized side effects such as compensatory sweating and thermo-regulation problems are not a side effect. The operation is done under light general anesthesia, it takes about an hour and it involves two small cuts in each armpit. This procedure is offered by hyperhidrosis expert Dr. Reisfeld in Los Angeles. To learn more please visit his page on excessive armpit sweating.

Why people get palmar hyperhidrosis?
As far as we know now excessive hand sweating or palmar hyperhidrosis is genetically determined. The gene is dominant but the penetration within the same family varies. It is not a psychological problem and it is a totally involuntary action. The possibility of gene manipulation as a treatment modality is still far away from being developed. Hopefully in the future this will enable physicians and researchers to treat this ailment without surgery.

What hope is there for people suffering from hyperhidrosis?
There are several options available for treating this condition. Conservative methods such as lotions, pills, or electric instruments (Iontophoresis machines) do not show good long-term results. Sympathectomy at present is the only known long-term cure for palmar hyperhidrosis.

So far genetic manipulation will be the best option to treat excessive hand sweating. At present it is only a futuristic possibility but as genome project is slowly advancing we hope that in the future a genetic solution will be found.

How long do the different procedures last?

Endoscopic Thoracic Sympathectomy (Hands)

Normally the ETS procedure is quite short. Patients usually can leave the same day. Recovery to normal life is attained within a few days.

Endoscopic Lumbar Sympathectomy (Feet)

This operation takes longer than ETS and it can last about an hour and a half to two hours. Since about 2009 the operation can be done on an outpatient basis meaning the patient leaves the surgical facility on the same day.

Is reversal possible for the ETS procedure?

Yes it is depending on the type of procedure done. Read More

Are there non sugical treatements?

Yes there are non surgical treatements available see our links page

Are there side affects to ETS?

Yes. Compensatory sweating is one of the most common side effects to the ETS procedure. In most situations the compensatory sweating is favorable to the original hyperhidrosis.

Sympathectomy vs. sympathotomy are they the same?

Recently the term sympathectomy has been replaced by the word sympathotomy on some websites. Many patients are wondering what the difference is. To simplify this confusion both have basically the same end result in which the sympathetic chain is rendered inactive either by destructional methods (cauterization or excision). In sympathotomy the same end result is achieved with the clamping method in which small titanium clamps are used.

For more frequently asked questions please go to:
Hyperhidrosis Frequently Asked Questions Page - At The Center For Hyperhidrosis.

Does insurance cover operations for hyperhidrosis?

For most of the cases for localized hyperhidrosis (hands and feet) insurance companies as a general rule pay for it as long as it is not excluded from their benefits plan. A patient also must show they at least tried conservative treatments first before embarking on surgical approach. Typically the surgeons office will help patients work through this process with their insurance companies.

The current surgical procedures for excessive armpit sweating are typically not covered by insurance companies.

Learn more about hyperhidrosis:


How old do you have to be to have the hyperhidrosis surgery? Are there age restrictions?

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